The CDC (Centers for Disease Control and Prevention) usually solves medical mysteries in record time, as evidenced by the recent bagged spinach health scare.
However, when it comes to autism, the CDC has been slow and subversive in its genuine investigations. After more than ten years of insistent parental pressure, the CDC still does not know what causes autism, even though it has estimated the average prevalence of autistic disorders at 1 in 150 children born in 1994. This may have been because any association between autism and MMR vaccination or Thimerosal was always ruled out a priori.
This report will review several aspects of the long-running Autism-Vaccine debate, and will show that the CDC failed to reveal important data that would have contradicted its public stance and supported and encouraged questionable epidemiological research denying any association between vaccination and regression.
Unless there is a serious change in philosophy at the highest level, the CDC will fail to solve the most important and destructive medical mystery it has ever faced – Autism
Packaged E Coli 0157
The Communicable Disease Center (CDC) was organized in Atlanta, Georgia, on July 1, 1946. I had the pleasure and privilege to work with several CDC field investigators in the late fifties and early sixties and was thoroughly impressed with their competence and ability.
I was again just as impressed with them forty five years later.
On Thursday September 14, 2006, the CDC, now The Centers for Disease Control and Prevention, issued an official "Health Alert" about an outbreak of fifty cases of confirmed E. coli O157:H7 infections.
The first affected patients became symptomatic between August 25 and September 3, 2006. Within three weeks, the CDC investigators knew that pre-packaged spinach was the most likely source of the infection and were well on their way to identify the brand and source.
Meanwhile, to protect the public and stop the outbreak, they were already advising everyone to avoid bagged spinach.
The CDC issued fifteen more reports during the next four weeks1. The last report on October 6 revealed that a total of 199 persons from 26 states had been infected, 102 were hospitalized and 3 died.
When it came to infected spinach, and two hundred U.S. citizens with diarrhea, the CDC was able to investigate the problem, find the cause, stop the outbreak and limit the damage in record time.
1 in 150 and counting
On February 8, 2007, the Centers for Disease Control and Prevention announced the results of two studies in a peculiarly-worded press release titled "CDC Releases New Data on Autism Spectrum Disorders (ASDs) from Multiple Communities in the United States".
The data in question were not exactly "NEW". The two studies were carried out in 2000 and 2002 and included children who were eight years old and born around 1992 - 1994.
According to the press release "…For decades, the best estimate for the prevalence of autism was four to five per 10,000 children. More recent studies from multiple countries using current diagnostic criteria conducted with different methods have indicated that there is a range of ASD prevalence between 1 in 500 children and 1 in 166 children…Overall, the 2000 study found ASD rates ranged from one in 222 children to one in 101 eight-year old children in the six communities studied. The 2002 study found ASD rates ranging from one in 303 to one in 94 among eight-year old children. The average finding of 6.6 and 6.7 per 1,000 eight-year-olds translates to approximately one in 150 children in these communities. This is consistent with the upper end of prevalence estimates from previously published studies, with some of the communities having an estimate higher than those previously reported in U.S. studies."
The press release was timed to coincide with the publication of the Morbidity and Mortality Weekly Report (MMWR) of February 9, 20072 and the release of a Fact Sheet by the Department of Health and Human Services (HHS), basically a report and update from the Autism and Developmental Disabilities Monitoring (ADDM) Network.3 Both are worth reading in their entirety.
In the fact sheet, the CDC announced that it will soon publish "updated reports from the ADDM Network on the prevalence of ASDs in multiple areas in the United States in 2004 and 2006".
The extensive Morbidity and Mortality Weekly Report described in detail the results of the 2002 study by behavioral scientist Catherine Rice, PhD, of the National Center for Birth Defects and Developmental Disabilities.
The three paragraphs under the heading "Developmental Characteristics" are most revealing.
"Children with a previously documented ASD classification included those who had received special education services under an autism special education eligibility and those with a clear diagnosis of ASD documented in the education or health source records, or both. Across the sites for which education information was accessible, the proportion of children identified with ASDs receiving special education services with an autism eligibility ranged from 31% in Colorado to 74% in Maryland. The prevalence estimates derived for children aged 8 years with ASDs who had a previously documented ASD classification ranged from 2.2 per 1,000 population in Alabama to 7.4 per 1,000 population in New Jersey. For all sites, the prevalence calculated from having a previous classification of ASD was lower than the ADDM Network prevalence of having an ASD. These results indicate that if an ASD is identified on the basis only of a documented diagnosis or eligibility for autism on record, prevalence would have been underestimated by as much as 30%.
An experienced clinician using standardized methods can reliably diagnose autism in children as young as age 2 years (45). Across the ADDM Network sites, the majority of children aged 8 years had diagnostic evaluations indicating general developmental concerns before age 3 years. Concerns in language development were generally noted at younger ages than concerns in social or imaginative play. However, age at first documented ASD diagnosis in the reviewed records varied greatly, from 10 months in the areas studied in Alabama to as late as 8 years, 10 months in the areas studied in Arkansas, Missouri, and West Virginia. These data confirm an earlier report (46) that a significant lag exists between early concerns and actual identification of an ASD as reported in records in multiple areas of the country, contributing to potentially significant delays in intervention. Given the benefit of early intervention (47), identification of an ASD at earlier ages in the United States is essential to ensure that children receive optimal early intervention services. CDC has been working with caregiver and professional groups to improve the early recognition of developmental concerns and to improve referral for further evaluation and intervention with the "Learn the Signs. Act Early." public awareness campaign (48).
Children with an ASD can experience a loss of developmental skills or a plateau in development, or both. Across all ADDM Network sites, 2%--13% of children had a plateau in development that was significant enough to be reported in a developmental evaluation. In addition, 14%--32% of the children were noted to have lost developmental skills at young ages, usually before age 2 years. The majority of ADDM Network sites reported developmental regression below the proportion reported from another study (49) that suggested that 25%--33% of children with an ASD are reported to experience a loss of developmental skills by the second year of life. However, the distinction between a loss of skills and a plateau in skills has not been made in previous studies. Reliance on existing records might not adequately ascertain this feature because certain providers might not evaluate or document the potential for developmental regression. Therefore, these results should be considered a minimal estimate of plateau and regression among ASD cases."
It appears from the above that,
|The prevalence of ASDs among children born in 1994 in New Jersey was as high as 7.4 per 1000 population.
|If an ASD was identified only on the basis of a documented diagnosis or recorded eligibility for autism, actual prevalence could have been underestimated by as much as 30%.
|An experienced clinician using standardized methods can reliably diagnose autism in children as young as age 2 years. [I guess we did not "miss" the diagnosis, as some have claimed.]
|Developmental concerns usually existed before the age of 3 and language difficulties were first to be noted.
|An early diagnosis resulted in a better the outcome.
|Neither prevention nor vaccines were apparently deemed relevant or worth mentioning.
In the last paragraph of the report, the author stated that 14 to 32% of the children in the study lost developmental skills, most of them before the age of 2 years, and that the majority of study sites reported lower rates of developmental regression than those reported in an unrelated previous study where 25-33% of children with ASD lost developmental skills by the second year of life.
This is clearly different from what we have known and firmly believe. The greatest majority of parents who have contacted me over the years reported a plateau followed by regression, most often between 18 and 24 months of age, among their affected children
Bernard Rimland PhD, who collected information on thousands of affected children stated repeatedly that the regressive form of autism had increased dramatically. On July 14, 2003 his statement was unequivocal: "Late onset autism, (starting in the 2nd year), was almost unheard of in the 50s, 60s, and 70s; today such cases outnumber early onset cases 5 to 1, the increase paralleling the increase in required vaccines."4
A real increase
According to the February 2007 press release, CDC Director Julie Gerberding, MD, MPH was still stating "…we can't yet tell if there is a true increase in ASDs or if the changes are the result of our better studies" while Marshalyn Yeargin-Allsopp, MD, Chief, Developmental Disabilities Branch, CDC's National Center on Birth Defects and Developmental Disabilities (NCBDDD), the scientist in charge of the CDC's autism program was finally conceding "…these studies …do confirm that ASDs in the areas surveyed are more common in these communities studied than previously thought…"
Catherine Rice PhD, the study lead investigator concluded her report with the statement "ADDM Network data provide a solid baseline prevalence with which future estimates can be compared. They also confirm that ASDs are more common than previously thought and are conditions of urgent public health concern."
Obviously we the parents and grandparents of children with autism have been saying that for years. In 1999, California published its first autism report5 and I wrote my very first piece on the subject "Autism 99: A National Emergency".6
And what has the CDC done since then?
It led a chorus chanting that there was no actual increase in autistic syndromes. The most tragic proof and result of this stonewalling – mostly intended to deny a vaccine connection - was that, in February 2007 the CDC was still confirming "… these studies did not investigate the causes of ASDs …" and Dr. Yeargin-Allsop was calmly asserting "We don't know the causes of ASDs".
It is important to point out that although the "new" studies were about children born in 1992-1994, the statement "We don't know the causes of ASDs" represents the current position of the CDC.
So how is it that the CDC could solve the spinach mystery, and the very recent peanut butter-salmonella enigma in no time and yet no one at the agency, including the NCBDDD director, has any clue about the causes of the biggest childhood plague in our history? And why are diagnosed cases of autism still increasing in California as of the last quarter of 2006?7
Genetic or environmental
Regardless of the predisposing genetic causes we are likely to discover, autism and autistic spectral disorders cannot possibly be increasing in such outlandish proportions without the direct influence of precipitating environmental triggers. Among those, mandated pediatric vaccinations, whether they contain Thimerosal or not, must be considered and seriously and honestly investigated.
My own research has focused on MMR vaccination and the effect of repeated administration of live virus vaccines to women during their child-bearing years. I have little doubt that among that particular small group of women, there is a direct connection between such vaccination and the development of autism among their children. I am also absolutely convinced that Andrew Wakefield’s research is honest and valid.
From the top
As long as the CDC and the Institute of Medicine are more interested in protecting vaccination programs than in controlling autism, very little will be done towards investigating the role of vaccines, additives and preservatives as triggers of autistic regressions. This became evident when Dr. Marshalyn Yeargin-Allsopp became head of the national autism program and director of the NCBDDD without even a public announcement. Dr. Yeargin-Allsop just as quietly became a member of the Scientific Affairs Committee of Autism Speaks, probably the largest, wealthiest and most influential U.S. parents association.8 The committee’s "scientific and medical experts meet regularly to direct policies and research for Autism Speaks".
The Wakefield hypothesis that autistic regression was possibly related to MMR vaccination in a small subset of genetically predisposed children has been a thorn in the side of the vaccine authorities since 1998.
On Tuesday, May 30, 2000 at 2:36 PM, Dr. Yeargin-Allsopp, then an epidemiologist at the NCBDDD, sent the following e-mail to Dr. Jose Cordero, at the time the Deputy Director of the National Immunization Program (NIP) of the CDC (Exhibit I):
As we discussed on Friday, we have become aware through Poul Thorsen of an exciting opportunity to study the role of MMR vaccine and autism using several registries/existing studies and the repository of biologic specimens and laboratory capabilities in Denmark. Attached below is a proposal for such a study. Poul will be leaving on Thursday to travel to Denmark where he will be meeting with the PIs for the proposed study on June 6th. We would like to be able to have Poul say whether it is likely that CDC (NIP) can fund the study, if NIP is interested. The proposed budget is included; there may be additional sources of funding (in addition to NIP) but we are not certain at this time. Unfortunately, the DD Branch does not have much (if any) $$ to fund the study, but we do have the expertise that we have developed due to the autism surveillance in Atlanta and the MMR/autism case-control study. I will be out of the office tomorrow, but you may contact Diana or Poul if you have questions. Thank you so much for considering this proposal. Marshalyn."
The "additional source of funding" mentioned was NAAR, the National Alliance for Autism Research, at the time a very active and wealthy parents group led by psychiatrist Eric London, MD.
NAAR has now merged with Autism Speaks and Dr. London serves with Dr. Yeargin-Allsopp on the same Scientific Affairs Committee.
So here we were in 2000
|Catherine Rice PhD of the NCDBBB is conducting a study on the prevalence of autistic disorders among eight year old children in several U.S. regions and finding alarming rates
|Marshalyn Yeargin-Allsopp MD of the same Center is soliciting funds from the National Immunization Program, whose function is to provide "leadership for the planning, coordination, and conduct of immunization activities nationwide"9 to fund a Danish study on MMR and autism, that would be co-authored by none other than Diana Schendel PhD, another NCBDDD epidemiologist
Sounds strange? Not really.
The resulting CDC funded/authored Madsen MMR study was intended to prove that MMR vaccination was not related to the development of autistic disorders in a few hundred children in Denmark. It was published in the New England Journal of Medicine on November 7, 200210, when Dr. Catherine Rice was discovering that on average, 1 in 150 US children had an ASD.
The Goldman and Yazbak Original Investigation11 published in the fall of 2004 revealed several problems with the Madsen MMR study and a more recent review by the Cochrane Collaborative concurred that the "Big MMR Study from Denmark" had problems.12
The safe mercury
While his MMR study was being published, Madsen was working on a follow-up study about Thimerosal and autism in Denmark.13
"A total of 956 children with a male-to-female ratio of 3.5:1 had been diagnosed with autism during the period from 1971-2000. There was no trend toward an increase in the incidence of autism during that period when thimerosal was used in Denmark, up through 1990. From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal."
So, less than 1000 Danish children had been diagnosed with autism over a period of almost 30 years or around 32 a year, and we were supposed to believe that their experience, with a totally different vaccination profile, was sufficient evidence to prove that the large amounts of Thimerosal in the many US pediatric vaccines that were used in 80’s and the 90’s were perfectly innocuous.
But more importantly, a review of e-mails exchanged between the Danish researchers and the CDC reveals that the statement "From 1991 until 2000 the incidence increased and continued to rise after the removal of thimerosal from vaccines, including increases among children born after the discontinuation of thimerosal" may not have been true.
In an e-mail on 11/13/2002 at 09:24, "co-author" Marlene B. Lauritsen informed Drs. Madsen, Thorsen and Schendel of the CDC:
"But the incidence and prevalence are still decreasing in 2001".
The sentences, before and after that unequivocal statement, were blackened with a magic marker before they were released through the Freedom of Information Act. (Exhibit II)
Another e-mail from Dr. Schendel dated 12/13/2002 at 21:05 (Exhibit III) read:
Hi Kresteen and Poul (referring to Drs. Madsen and Thorsen)
We are having persistent questions from one of the congressional offices
about data on the prevalence of autism in Denmark – in response to the NEJM
article. I keep telling them that the information has been submitted for
publication. I am not a co-author, and I can not give out any information
that is under per review (apart from the fact that I don’t have the actual
data) - professional courtesy and ethics and good science practice) just
will not allow such mishandling. Coleen has been saying the same thing when
they go to her (I didn’t know that).
But they have now asked if we can tell them the subject matter of the paper. So what do you feel about this. xxxxx
Don’t feel like you have to say yes to this request – no pressure at all…
Again, absolutely no pressure to comply. And we wanted to get your permission before we say anything.
Have a good weekend.
The above is self-explanatory. As seen in the attached exhibit, the title proposed by Dr. Schendel was also obscured with a magic marker.
Dr Thorsen responded 26 minutes later (12/13/2002 at 21:31)
It certainly would be interesting to know what Dr. Thorsen added that needed to be kept secret.
The response from Dr. Madsen came on 12/16/2002 at 6:48 AM
Subject: q on thimerosal and autism paper
Hi Poul and Diana
Just to tell you that I agree with Pouls suggestion of referring to Marlene.
The above suggests that Dr. Marlene Lauritsen may have been the real lead author of the paper.
Leaning on the Editor and the IOM
It was decided that Coleen Boyle. PhD ("Coleen" in Dr, Schendel’s e-mail) would compose the letter of support to the Editor of PEDIATRICS. On Thursday December 5, 2002 at 2:51 PM, Dr. Boyle sent an e-mail to Dr. Jose Cordero with copy to Dr. Yeargin-Allsopp, about the letter of support. (Exhibit IV)
The following day at 3:47 PM, Dr. Boyle e-mailed her proposed letter to Dr. Cordero [Subject: FW: Letter of support for Danish Study – for Jose’s review and cmt (and signature)].
On December 10, 2002, Assistant Surgeon General Jose F. Cordero MD, MPH, now the Director, National Center on Birth Defects and Developmental Disabilities sent a long "personal" letter to Jerold F. Lucey, MD, the editor of PEDIATRICS.14
The letter started:
"I am writing in support of an expedited review and consideration of the enclosed manuscript that examines the association between thimerosal, an ethyl mercury containing preservative and autism. As you may know, there has been considerable interest by parents, clinicians, educators, and policy makers for an explanation of the marked increase in the rate of autism."
Of note is the fact that Cordero, who must have been aware of the results of Dr. Rice’s research refers to the "marked increase in the rate of autism" without citing better diagnosis and or looser criteria. As intriguing is the fact that Cordero and Boyle felt they needed to inform the editor of PEDIATRICS that thimerosal contains ethyl mercury.
Cordero (or Boyle) went on:
"…In addition, a key strength of the study is the ability to examine rates of autism prior to and after the discontinuation of vaccines containing thimerosal in Denmark in 1992. Contrary to what would be expected if thimerosal was linked to autism, the authors did not observe a decline in the rate of autism with the removal of thimerosal containing vaccines."
No one knows for sure, and it is a good bet that no one will ever know, whether Dr. Cordero had been made aware that the rates of autism were actually decreasing in Denmark in 2000, when Madsen and friends were reporting that they were "continuing to rise".
On the other hand, Cordero must have been aware that children in Denmark were receiving two doses of MMR in record numbers, while autism and ASD rates were increasing during the few years that immediately followed the 1992 Thimerosal ban.
Dr. Cordero ended his letter by the very intimidating statement:
I feel this is a very important study that deserves thoughtful
consideration by the Journal. Its findings provide one strong piece of
evidence that thimerosal is not causally linked to autism. Thank you for
|An epidemiologist from NCBDDD conducts two large studies on the prevalence of autism spectrum disorders among eight year old children in several states in 2000 and 2002 but the Center and the CDC keep the impressive prevalence of 1 in 150 secret until 2007
|While the second Rice study is going on and disturbing results are coming in, another epidemiologist from the Center who is not a co-author, becomes aware that the reported data is flawed and instead of screaming foul, she collaborates with the Danish researchers, instructs them about what to say or not to say re inquiries by a United States Congressman and offers to draft a letter of support to the Editor of PEDIATRICS
|Another PhD at NCBDDD drafts the letter in question and the director signs it and mails it to the editor.
|The "Madsen Thimerosal study" is published in September 2003
|Other questionable thimerosal – autism research from England and Denmark is also hastily produced and published that year
|All these publications are taken seriously and a special committee of the Institute of Medicine decides in a few hours on February 9, 2004 that thimerosal is not causally linked to the increase in autism
|This same committee also decrees that MMR vaccination never caused autism and that further research into a thimerosal or MMR -autism connection should never be undertaken in the future.
The whole sordid saga was reviewed by Representative Dave Weldon of Florida in his unforgettable speech
"Something is Rotten, But Not Just in Denmark".15
Dr. Weldon was evidently right.
|When our CDC detectives want to find something they do.
|The CDC is not willing to consider any causes of autism remotely related to vaccinations
|Scientists at NCBDDD seem more interested in proving that vaccines are NOT involved than in finding the cause of the national calamity that they have kept secret for FIVE years
|No reporter has enough courage to talk about the best available treatment for many individuals with autism, namely the gluten-free / casein–free diet, so as not to suggest an MMR connection
|Many "experts" still insist that autism did not increase or that we were too dumb to recognize the syndrome
|Others concede that there is an increase but have no idea where it is coming from
|Scientists reinforce these silly notions by writing flawed and absurd epidemiological reports, sometimes funded by the vaccine authorities or manufacturers
|The CDC and others finance and help publish irrelevant research about "selected" populations during "result-favorable" periods
|Editors accept and publish research from far away lands but reject valid criticism of said research by reputable scientists
|A foreign psychiatrist becomes an expert on Thimerosal and autism before publishing a single paper on the subject
|Physicians and vaccine "experts" accuse anyone who dares question the status quo, of heresy and the endangerment of children
|Some parents associations are still unaware that prevention must be the first priority and do not realize that there cannot be a cure for autism until a cause is found
|A generation of children has now been lost
1 Updates From the Multi-State Outbreak of E. coli O157:H7 Infections From Fresh Spinach, September–October 2006 ~ http://www.cdc.gov/ecoli/2006/september/updates/
CDC, MMWR Surveillance Summaries February 9, 2007 / 56(SS01);12-28
Prevalence of Autism Spectrum Disorders --- Autism and Developmental
3 Department of Health and Human Services, Fact Sheet, CDC Autism Activities http://www.cdc.gov/ncbddd/autism/documents/FACTSHEETAutismGeneral%20February7_2007%20_2_.pdf
THE AUTISM EPIDEMIC IS REAL, AND EXCESSIVE VACCINATIONS ARE THE CAUSE
11 Goldman GS, Yazbak FE. An
investigation of the association between MMR vaccination and autism
12 Review Paper: Demicheli et al: Vaccines for measles, mumps and rubella in children. The Cochrane Database of Systematic Reviews 2005, Issue 4.
Dedicated to the Memory
Of two sorely missed warriors
Liz Birt & Bernie Rimland
Williams, Lisa (NIP)
Sent: Wednesday, August01, 2001 2:04 PM
To: Williams, Lisa (NIP)
Subject: FW: Proposal for study of MMR vaccine and autism in Denmark
From: Destefano, Frank
Sent: Thursday, June 01, 2000 12:41 PM
To: Bernier, Roger
Subject: RE: Proposal for study of MMR vaccine and autism in Denmark
I hadn’t seen it, but it looks like a good opportunity. The availability of data from pregnancy, as well as blood specimens, is particularly attractive. The blood spot component would be very valuable just by itself to try to confirm the exciting findings from the small NIH study. If these are true biomarkers for autism, it would be great to see if they identify high risk groups of kids for a vaccine-autism association. In addition to MMR, the study should include all infant and childhood vaccines to look at issues of multiple antigens, vaccine additives, etc. Serologies for measles and rubella in the maternal and cord blood might also be worth considering.
From: Bemnier, Roger
Sent: Tuesday, May 30, 2000 5:35 PM
To: Destefano, Frank; Chu, Susan
Subject: FW: Proposal for study of MMR vaccine and autism in Denmark
Have you folks heard of this or seen this? It is a short turnaround but can you weigh in on this. Thanks
From: Cordero, Jose
Sent: Tuesday, May 30, 2000 5:32 PM -
To: Bernler, Roger
Subject: FW: Proposal for study of MMR vaccine and autism in Denmark
I got this-from Marshallyn. Would appreciate your comments.
José - -
From: Yeargin-Alisopp, Marshalyn -
Sent: Tuesday, May 30, 2000 2:36 PM
To: Cordero, Jose
Cc: Schende~, Diana; Murphy, Catherine; Boyle, Coleen; Decoufle, Pierre; Thorsen, Poul; Yeargin-Allsopp, Marshatyn; Sinks, Tom
Subject: Proposal for study of MMR vaccine and autism in Denmark
Jose, As we discussed on Friday, we have become aware through Poul Thorsen of an exciting opportunity to study the role of MMR vaccine and autism using several registries/existing studies and the repository of biologic specimens and laboratory capabilities in Denmark. Attached below is a proposal for such a study. Poul will be leaving on Thursday to travel to Denmark where he will be meeting with the PIs for the proposed study on June 6th. We would like to be able to have Poul say whether it is likely that CDC (NIP) can fund the study, if NIP is interested. The proposed budget is included; there may be additional sources of funding (in addition to NIP) but we are not certain at this time. Unfortunately, the DD Branch does not have much (if any) $$ to fund the study, but we do have the expertise that we have developed due to the autism surveillance in Atlanta and the MMR/autism case-control study. I will be out of the office tomorrow, but you may contact Diana or Poul if you have questions. Thank you so much for considering this proposal.
F. Edward Yazbak MD, FAAP
March 1, 2007